TY - JOUR
T1 - Population-based prevalence of infarctions on 3D fluid-attenuated inversion recovery (FLAIR) imaging
AU - Cogswell, Petrice M.
AU - Aakre, Jeremiah A.
AU - Castillo, Anna M.
AU - Knopman, David S.
AU - Kantarci, Kejal
AU - Rabinstein, Alejandro A.
AU - Petersen, Ronald C.
AU - Clifford, R. Jack
AU - Mielke, Michelle M.
AU - Vemuri, Prashanthi
AU - Graff-Radford, Jonathan
N1 - Funding Information:
P.M.C., J.A.A., A.M.C., and A.A.R. report no competing interests. D.S.K. served on a Data Safety Monitoring Board for the DIAN study. He served on a Data Safety Monitoring Board for a tau therapeutic for Biogen, but receives no personal compensation. He is an investigator in clinical trials sponsored by Biogen, Lilly Pharmaceuticals, and the University of Southern California. He serves as a consultant for Samus Therapeutics, Third Rock, and Alzeca Biosciences but receives no personal compensation. He receives research support from the NIH. K.K. serves on the data safety monitoring board for Takeda Global Research & Development Center, Inc; receives research support from Avid Radiopharmaceuticals, Inc, and Eli Lilly and Co; and receives funding from NIH and the Alzheimer's Drug Discovery Foundation. R.C.P. has consulted for Roche, Inc.; Merck, Inc.; Biogen, Inc.; Eisai, Inc. and is on a Data and Safety Monitoring Committee for Genentech, Inc. He receives research support from the National Institute on Aging, the GHR Foundation, and the Alzheimer's Association. C.R.J. serves on an independent data monitoring board for Roche and has consulted for Eisai, but he receives no personal compensation from any commercial entity. He receives research support from NIH and the Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic. M.M.M. reports consulting for Brain Protection and receiving research funding from the NIH, and Biogen. P.V. receives research funding from the NIH. J.G.R. is funded by the National Institute of Aging of the National Institutes of Health (NIH) under Award Number K76AG057015.
Funding Information:
This work was supported by the National Institutes of Health [ U01 AG006786 , R37 AG011378 , RO1 AG041851 , RO1 NS097495 , and RO1 AG056366 ].
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/8
Y1 - 2022/8
N2 - Objectives: To report population-based, age-specific prevalence of infarctions as identified via 3D fluid-attenuated inversion recovery (FLAIR) imaging. Materials and Methods: Participants without dementia in the Mayo Clinic Study of Aging (MCSA), a population-based study in Olmsted County, MN, age 50-89 who underwent 3D FLAIR imaging between 2017 and 2020 were included. Infarctions per participant were determined via visual interpretation. Inter- and intra-reader reliability were calculated. Infarction prevalence on 3D FLAIR was derived by standardization to the Olmsted County population and was compared to that previously reported on 2D FLAIR imaging. Results: Among 580 participants (mean age 71 years, 46% female) the prevalence (95% confidence interval) of any infarction was 5.0% (0.0%-9.9%) at age 50-59 years and 38.8% (28.6%-49.0%) at 80-89 years. In addition to increasing with age, the prevalence varied by sex and type of infarction. Prevalence estimates of cortical infarcts were 0.9% (0.0%-2.7%) at age 50-59 years and 20.2% (10.7%-29.7%) at 80-89 years and lacunar infarcts 4.1% (0.0%-8.8%) at age 50-59 years and 31.2% (21.5%-41.0%) at 80-89 years. Prevalence estimates of any infarction by sex were: men, 8.7% (0.0%-18.7%) at 50-59 years and 54.9% (41.0%-68.8%) at 80-89 years and women, 2.4% (0.0%-7.3%) at age 50-59 years and 27.3% (12.9%-41.7%) at 80-89 years. Intra- and inter- reader reliability were very good (kappa = 0.85 and 0.82, respectively). After adjusting for age, sex and education, individuals imaged with 3D FLAIR were 1.5 times (95% CI 1.2-1.8, p<0.001) more likely to be identified as positive for infarction compared to those imaged with 2D FLAIR. Conclusions: Infarction prevalence increases with age and is greater in men than women. Infarction prevalence on 3D FLAIR imaging, which has become more widely implemented as an alternative to 2D FLAIR over the past several years, will be a useful reference in future work.
AB - Objectives: To report population-based, age-specific prevalence of infarctions as identified via 3D fluid-attenuated inversion recovery (FLAIR) imaging. Materials and Methods: Participants without dementia in the Mayo Clinic Study of Aging (MCSA), a population-based study in Olmsted County, MN, age 50-89 who underwent 3D FLAIR imaging between 2017 and 2020 were included. Infarctions per participant were determined via visual interpretation. Inter- and intra-reader reliability were calculated. Infarction prevalence on 3D FLAIR was derived by standardization to the Olmsted County population and was compared to that previously reported on 2D FLAIR imaging. Results: Among 580 participants (mean age 71 years, 46% female) the prevalence (95% confidence interval) of any infarction was 5.0% (0.0%-9.9%) at age 50-59 years and 38.8% (28.6%-49.0%) at 80-89 years. In addition to increasing with age, the prevalence varied by sex and type of infarction. Prevalence estimates of cortical infarcts were 0.9% (0.0%-2.7%) at age 50-59 years and 20.2% (10.7%-29.7%) at 80-89 years and lacunar infarcts 4.1% (0.0%-8.8%) at age 50-59 years and 31.2% (21.5%-41.0%) at 80-89 years. Prevalence estimates of any infarction by sex were: men, 8.7% (0.0%-18.7%) at 50-59 years and 54.9% (41.0%-68.8%) at 80-89 years and women, 2.4% (0.0%-7.3%) at age 50-59 years and 27.3% (12.9%-41.7%) at 80-89 years. Intra- and inter- reader reliability were very good (kappa = 0.85 and 0.82, respectively). After adjusting for age, sex and education, individuals imaged with 3D FLAIR were 1.5 times (95% CI 1.2-1.8, p<0.001) more likely to be identified as positive for infarction compared to those imaged with 2D FLAIR. Conclusions: Infarction prevalence increases with age and is greater in men than women. Infarction prevalence on 3D FLAIR imaging, which has become more widely implemented as an alternative to 2D FLAIR over the past several years, will be a useful reference in future work.
KW - Cerebrovascular disease
KW - Infarction prevalence
KW - Magnetic resonance imaging (MRI)
KW - Population studies
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U2 - 10.1016/j.jstrokecerebrovasdis.2022.106583
DO - 10.1016/j.jstrokecerebrovasdis.2022.106583
M3 - Article
C2 - 35689933
AN - SCOPUS:85132567177
SN - 1052-3057
VL - 31
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 8
M1 - 106583
ER -